Fixed combination perindopril arginine/indapamide currently represents the optimalisation of the treatment of arterial hypertension thanks to strong evidence based medicine. In this article we give an overview of the benefits of the treatment with this combination according to the current Guidelines for the treatment of arterial hypertension. What could not be omitted is the effect on coronary microvascular dysfunction and metabolic profile of the patient. The treatment with ACE inhibitors appears to have more advantages in terms of end organ protection than the treatment with AT1 receptor blockers for angiotensin II. The latest NICE Guidelines recommend indapamide instead of hydrochlorothiazide. The position of this fixed combination in the current strategy of the treatment of hypertension is unique and excellently proven in many multicentre studies worldwide.